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Health Studies
Denis Maxwell

HLTC02 WINTER 2013 Week # 9: In Search of a Healing Place: Aboriginal Women in Vancouver’s Downtown East Side by Cecilia Benoit, Dena Carroll and Munaza Chaudhry Abstract  Aboriginal people face formidable barriers in accessing CULTURALLY appropriate and timely care  Urban Aboriginal Health Centres (UAHCs) have emerged to address the unmet health concerns of Aboriginal people in metropolitan areas  Purpose of Research: address gap of how health care concerns of AW are bing unmet by UAHCs  Case Study approach with 4 focus groups of aboriginal women (Vancouver Native Health Society, Sheway and residents of Vancouver‟s Downtown East Side (DTES)  25 semistructred interviews were conducted with VNHS staff, health providers, government representatives, and community leaders in health care  Aboriginal women have expressed a strong desire for a healing place, an integrated health centre that serves to address their physical, mental, emotional and spiritual needs, incorporates both Aboriginal and Western healing and medical practices Introduction  1.1 million people claimed Aboriginal ancestry in 1996 – approximately 4018,100 are women  Aboriginals are more likely to live in SINGLE parent families, have higher rates of UNEMPLOYMENT, lower rates of HIGHSCHOOL COMPLETION, poor health status  Aboriginal people have lower life expectancies than the general population, more than half in urban centres and over 66% percent in Western Canada, diverse, youthful and growing population  Urban aboriginal people have higher rates of homelessness, greater housing needs, higher rates of suicide, at particularly high risk for substance abuse, TB, HIV/AIDS, or developing diabetes, lower median average income – compared to non-urban counterparts  Creation of Urban Aboriginal Health Centres (UAHCs) have emerged to address the unmet health concerns of Aboriginal people living in large metropolitan areas  Strategies used: control and administration by a qualified team of Aboriginal people, recruitment of Aboriginal health professionals, implementation of holistic philosophy of care that blends traditional Aboriginal healing and Western Medicine  Long term goal of UAHCs is to improve service delivery and health outcomes for urban Aboriginal people in Canada by increasing access to culturally suitable and appropriate health care and social services  Purpose of this research is the address the gap in social science literature on how effectively Aboriginal women‟s specific health concerns are being met by the innovative UAHCs in particular  Few reports available indicate Aboriginal women have inadequate access to reproductive care services, access to pap smears, mammogram screening and abortion services  Bulk of this paper centers around the care Aboriginal Women receive from three different types of services provided at VNHS – The walk in clinic, the positive outlook program and Sheway Research Design & Methods  Formulation of a Community Advisory Council comprising aboriginal and non-aboriginal professionals who provided advice, direction and guidance regarding research goals, recruitment strategies, interviewing and data analysis  Methods: participant observation, semi structured interviews and focus groups  Three focus groups o Vancouver Native Health Society clients o Clients of sister organization Sheway o Non-affiliated Aboriginal women living in DTES  25 semi structured interviews with VNHS and Sheway staff, health professionals, government health authorities and community health workers  Thematic analysis was used to analyze the data, direct representation of an individual‟s own point of view and descriptions of experiences, beliefs, and perception; gives voice to those who are HLTC02 WINTER 2013 usually silenced; present the lived experiences and meaning of those who are the main focus of the study  Constant Comparative Method – compare thematic findings of focus group transcriptions with the central themes emerging from the transcribed personal interview data  Qualitative studies limited in their ability to make generalizations about the entire population from a small sample,  Self selection bias also present – elderly and women not in crisis or those living in other residential neighborhoods in Vancouver were not able to give their input  Strength of this study – gives agency to participants whose needs are great and yet those voices are seldom heard Urban Ghetto: DTES  7%of Vancouver‟s residents are aboriginal people (28,000) people  Most DTES Aboriginal residents have been displaced or have migrated from other parts of Canada; housing is shoddy, not appropriate, lack basic amenities (fridge, stove, private bathroom, security, privacy and safety)  DTES overcrowded hotels and poor living conditions combined with substantial part of its population having unprotected sex and dependence on addictive injection based drugs has led to the highest rate of HIV/AIDS transmission in the Western world Aboriginal Women in DTES  3 to 1 ratio of males to females in DTES, but in urban ghetto aboriginal population it is roughly 50-50  70% of DTES sex workers are Aboriginal, average aboriginal sex worker is 26, 3 or more children and no high school education  Inadequate access to birth control, rising incidence of drug use and growing problem of AIDS are all problems for Aboriginal women in DTES  Aboriginal women are more likely than male counterparts to share needles, second on the needle and associate condom use or non use with important distinction between work and relational sex  Many women are migrants therefore are isolated, without a strong social support system or cultural base to access when in crisis  Homelessness is symptomatic of larger problems including substance abuse, mental health issues, family breakdown, underemployment, low income and racism  Aboriginal women are not merely voiceless victims of larger structural forces, they have sense of agency, a vision of how to change their situation, improve their health and ensure a better life for their children Vancouver Native Health Society  VNHS is provincially funded, non profit society that serves 50% European descent, 40% Aboriginal, and rest visible minority groups  Lack of qualified health professionals of Aboriginal heritage, poor representation of Aboriginals in staff of VNHS  Initially, there was the vision to have an on-site Aboriginal Healing Centre (AHC) but it didn‟t receive the ECONOMIC support needed, in addition, few traditional healers willing to work in clinical setting (due to adequate remuneration, urban setting, government regulation of traditional practices and threat to traditional knowledge contents)  Open Door Policy – open to Aboriginal and non-Aboriginal people alike o Yet it is not adequately meeting its mandate to serve Aboriginal People o Lack of aboriginal staff, elders  Programs and services at VNHS: Walk In Medical Clinic, Positive Outlook (an HIV/AIDS Home Health Care Program), The Sheway Project, Pre-recovery Empowerment Program (POP), TBSA Outreach Program (TB services for Aboriginals), DTES Health Outreach Van Program, Youth Safe House Project, & Inner City Foster Parents Project  POP – Traditional healing approaches have been included, popular among the local population afflicted with HIV/AIDS HLTC02 WINTER 2013  Walk I
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